Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity. Show
What is Hydrocephalus?Hydrocephalus affects hundreds of thousands of Americans, in every stage of life, from infants to the elderly.
ClassificationThere are two types of hydrocephalus:
PathophysiologyThe pathophysiology of hydrocephalus occurs as follows:
Statistics and IncidencesHydrocephalus cases are affecting the entire world every day.
CausesCauses usually are genetic factors and how the fetus develops.
Clinical ManifestationsClinical features of hydrocephalus are influenced by the patient’s age, the cause of the hydrocephalus, the location of the obstruction, its duration, and its rapidity of onset. Effect of hydrocephalus in the brain and cranium. Image via: wikipedia.org
Assessment and Diagnostic FindingsExamination in infants may include the following:
Medical ManagementThe goal of treatment in clients with hydrocephalus is to reduce or prevent brain damage by improving the flow of CSF which may include surgery to provide shunting for drainage of the excess fluid from the ventricles to an extracranial space such as the peritoneum or right atrium (in older children) or management with medications to reduce ICP if progression is slow or surgery is contraindicated. Pharmacologic TherapyThe following medications are used to treat hydrocephalus.
Surgical ManagementSurgical intervention is the only effective means of relieving brain pressure and preventing additional damage to the brain tissue.
Nursing ManagementManaging a child with hydrocephalus warrants skill and compassion for nurses and all the members of the healthcare team. Nursing AssessmentAccurate information is essential in the assessment of the child with hydrocephalus.
Nursing DiagnosesBased on the assessment data, the major nursing diagnoses are:
Nursing Care Planning and GoalsMain Article: 5 Hydrocephalus Nursing Care Plans The goals for the care of the newborn with hydrocephalus include:
Nursing InterventionsNursing interventions for the newborn with hydrocephalus include:
EvaluationGoals met are evidenced by:
Documentation GuidelinesDocumentation for a patient with hydrocephalus includes:
Practice Quiz: HydrocephalusHere’s a 5-item quiz about the study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. Bennett was rushed to the emergency department with possible increased intracranial pressure (ICP); which of the following is an early clinical manifestation of increased ICP in older children? (Select all that apply.) A. Macewen’s sign. 1. Answer: D. Diplopia. Diplopia is an early sign of increased ICP in an older child.
2. While performing a physical examination on a newborn, which assessment should be reported to the physician? A. Head circumference of 40 cm. 2. Answer: A. Head circumference of 40 cm. Average circumference of the head for a neonate ranges between 32 to 36 cm; an increase in size may indicate hydrocephalus or increased intracranial pressure.
3. Tiffany is diagnosed with increased intracranial pressure (ICP); which of the following if stated by her parents would indicate a need for Nurse Charlie to reexplain the purpose of elevating the head of the bed at a 10 to 20-degree angle? A. Help alleviate headache. 3. Answer: B. Increase intrathoracic pressure Head elevation decreases, not increases, intrathoracic pressure.
4. While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel is open. The nurse should: 4. Answer: A. Notify the doctor. Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding.
5. A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse expect to find? A. Closed anterior fontanel and open posterior fontanel. 5. Answer: C. Closed anterior and posterior fontanels. By age 18 months, the anterior and posterior fontanels should be closed.
What activity would the nurse expect to find in an 18 month old?What activity would the nurse expect to find in an 18-month-old? Toddlers continue to progress with motor skills. An 18-month-old should be able to climb stairs with assistance. A 24-month-old should be able to stand on his or her tiptoes and carry a large toy while walking.
Which social development task would the nurse anticipate when assessing a toddler1, 4, Separation and individuation are two social development tasks the nurse anticipates for the toddler-age client.
Which psychosocial changes does a 2 year old exhibit?Which psychosocial change does a 2-year-old child exhibit? A 2 year old engages in temper tantrums when parents start restricting certain activities to prevent harm. At 2 years of age, a child has a strong will and determination, which may result in negative behavior.
For which clinical manifestation should the nurse monitor the toddlerFor which clinical manifestation should the nurse monitor the toddler-age client diagnosed with lead toxicity associated with the renal system? Glycosuria is a clinical manifestation associated with the renal system that is caused by lead toxicity; therefore, the nurse should include this in the assessment process.
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